Journal article
Diagnosis of ischemia in hypertrophic cardiomyopathy: role of computed tomography and nuclear stress testing
Current opinion in cardiology, Vol.30(5), pp.483-492
09/01/2015
DOI: 10.1097/HCO.0000000000000201
PMID: 26165377
Abstract
Purpose of review
Chest pain and myocardial ischemia are common features in patients with hypertrophic cardiomyopathy (HCM). This review addresses diagnostic roles of computed tomography and nuclear stress testing (NST) in patients with HCM.
Recent findings
Current evidence showed the limitation of NST in the diagnosis of epicardial coronary artery stenosis due to the prevalent microvascular dysfunction. In this context, the excellent negative predictive value of coronary computed tomography angiography (CCTA) makes it very attractive to serve as a gatekeeper to invasive angiography in low-risk symptomatic patients, either as the first noninvasive imaging test of choice or after the presence of perfusion defect seen in NST. Furthermore, the identification of coronary atherosclerosis process in the absence of obstructive lesion could have impacts on the management of risk factors for coronary artery disease. We also propose an algorithm for evaluation of ischemia in HCM patients based on the recent evidence.
Summary
In low-intermediate-risk symptomatic patients with HCM, both NST and CCTA are acceptable diagnostic tools for the evaluation of myocardial ischemia. In the presence of nuclear perfusion defect, CCTA can be used to rule out significant epicardial stenosis. Presence of significant major epicardial artery stenosis on CCTA or high-risk patients could be considered for invasive angiography.
Details
- Title: Subtitle
- Diagnosis of ischemia in hypertrophic cardiomyopathy: role of computed tomography and nuclear stress testing
- Creators
- Kongkiat Chaikriangkrai - University of Arkansas for Medical SciencesLakshmi Chebrolu - Houston MethodistSabha Bhatti - University of Arkansas for Medical SciencesSu Min Chang - Houston Methodist
- Resource Type
- Journal article
- Publication Details
- Current opinion in cardiology, Vol.30(5), pp.483-492
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/HCO.0000000000000201
- PMID
- 26165377
- ISSN
- 0268-4705
- eISSN
- 1531-7080
- Number of pages
- 10
- Language
- English
- Date published
- 09/01/2015
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984361730102771
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